%0 Journal Article %T Syncope and subsequent traffic crash: a responsibility analysis %J PLoS one %D 2023 %A Staples, John A. %A Erdelyi, Shannon %A Merchant, Ketki %A Yip, Candace %A Khan, Mayesha %A Redelmeier, Donald A. %A Chan, Herbert %A Brubacher, Jeffrey R. %V 18 %N 1 %P e0279710-e0279710 %X BACKGROUND: Physicians are often asked to counsel patients about driving safety after syncope, yet little empirical data guides such advice.

METHODS: We identified a population-based retrospective cohort of 9,507 individuals with a driver license who were discharged from any of six urban emergency departments (EDs) with a diagnosis of 'syncope and collapse'. We examined all police-reported crashes that involved a cohort member as a driver and occurred between 1 January 2010 and 31 December 2016. We categorized crash-involved drivers as 'responsible' or 'non-responsible' for their crash using detailed police-reported crash data and a validated responsibility scoring tool. We then used logistic regression to test the hypothesis that recent syncope was associated with driver responsibility for crash.

RESULTS: Over the 7-year study interval, cohort members were involved in 475 police-reported crashes: 210 drivers were deemed responsible and 133 drivers were deemed non-responsible for their crash; the 132 drivers deemed to have indeterminate responsibility were excluded from further analysis. An ED visit for syncope occurred in the three months leading up to crash in 11 crash-responsible drivers and in 5 crash-non-responsible drivers, suggesting that recent syncope was not associated with driver responsibility for crash (adjusted odds ratio, 1.31; 95%CI, 0.40-4.74; p = 0.67). However, all drivers with cardiac syncope were deemed responsible, precluding calculation of an odds ratio for this important subgroup.

CONCLUSIONS: Recent syncope was not significantly associated with driver responsibility for traffic crash. Clinicians and policymakers should consider these results when making fitness-to-drive recommendations after syncope.

Language: en

%G en %I Public Library of Science %@ 1932-6203 %U http://dx.doi.org/10.1371/journal.pone.0279710